Purpose: College drinking continues to be a major public health concern. In search for solutions, a number of programs have been developed to reduce student drinking and minimize alcohol-related negative consequences. Previous reviews have criticized the methodological quality of college alcohol outcome studies but none have systematically evaluated where these methodological weaknesses lie. Poor methodological quality can confound the interpretation of outcome findings. The goal of this study was to conduct a systematic review of recent college drinking interventions to 1) determine the methodological quality of these studies, and 2) to identify which types of interventions are most effective in reducing alcohol use in general, heavy drinking in particular, and alcohol-related negative consequences while taking into consideration the methodological rigor of each study.

Methods: An extensive online and manual search for individual-focused college alcohol intervention studies published between 2000 and 2005 was conducted. Only studies that used a control or comparison group, utilized a pre-and posttest, and assessed at least one drinking-related behavioral outcome were included in this review. Each study was then carefully read and rated with regard to methodological quality on ten design attributes. The reported outcomes were then evaluated in light of the overall methodological quality of each study and the type of intervention used.

Results: The search process yielded 18 studies that met all inclusion criteria. The methodological quality of these studies varied with programs based on the motivational enhancement approach (8 studies) having the strongest overall methodology, followed by interventions using the social norms methods (7 studies) and those utilizing cognitive-behavioral strategies (3 studies). Motivational enhancement based programs were also most effective in reducing the general level of drinking, particularly with at-risk students. Heavy drinking was successfully reduced by a select number of both motivational enhancement and social norms based interventions. Reducing alcohol-related negative consequences proved to be the most challenging outcome to achieve.

Implications for practice: Evidence from the last five years suggests that programs based on the motivational enhancement approach that target at-risk drinkers show most promise in reducing alcohol use, particularly heavy drinking, among college students. Select number of social norms based interventions that provide at-risk student drinkers with individual normative feedback appear to be equally successful. There is less evidence regarding the efficacy and effectiveness of programs using only cognitive-behavioral strategies and those targeting the general student population. Future directions for college alcohol intervention research will also be discussed.